Hopkins, UM join suit on Medicare audits

MARYLAND WATCH

October 31, 1997

Johns Hopkins University and University Physicians, the faculty practice plan at the University of Maryland, are among the parties to a lawsuit challenging federal audits of Medicare billing by teaching hospitals.

The suit was filed Tuesday in federal court in California by the Association of American Medical Colleges, the American Medical Association and other professional associations, medical schools and teaching hospitals.

The 2-year-old audit program is aimed at making sure faculty doctors in teaching hospitals bill only for work they do directly, not for work done by residents. The audits also examine whether the work done is billed at the correct rate.

The teaching hospitals have complained that Medicare rules for billing were too vague and that the audit applies newly clarified rules retroactively. Also, they said, the government has been treating routine billing errors as fraud.

"Unfortunately, litigation now appears to be the only means available to ensure that the audits of teaching physicians are conducted in a uniform and equitable way," said Dr. Jordan J. Cohen, president of the AAMC.